Permit Ipl .' , CITY OF TIGARD
MECHANICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: MEC2007 - 00583
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 10/5/2007
PARCEL: 25111 CC - 00700
SITE ADDRESS: 10095 SW CENTURY OAK DR ZONING: R -7
SUBDIVISION: SUMMERFIELD LOT: 004 JURISDICTION: TIG
PROJECT: KOLINA
Project Description: Furnace and AC replace. Return air ducts, range venting, fan venting. Add gas to BBQ and fireplace.
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: VENT FANS: 2
OCCUPANCY GRP: R3 VENTS W/O APPL: VENT SYSTEMS:
.STORIES: BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: 1 DOMES. INCIN:
NAT 3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP:
FIRE DAMPERS ?: 30 - 50 HP: REPAIR UNITS:
GAS PRESSURE: 50 + HP: WOODSTOVES:
FURN < 100K BTU: 1 AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm:
GAS OUTLETS: 2
Owner: FEES
RON KOLINA Description Date Amount
10095 SW CENTURY OAK DR
TIGARD, OR 97224 [MECH] Permit Fee 10/5/2007 $72.50
[TAX] 8% State Surcha 10/5/2007 $5.80
Total $78.30
Phone: 503- 880 -5145
Contractor:
MC CLENNY /RHC •
PO BOX 329
CORNELIUS, OR 97113 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 357 -5663
FAX 503 -357 -0668
Reg #: LIC 142703
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and all other
applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these
rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By: 4'1 Permittee Signature: C
Call 503.639.4175 by 7:00 a.m. for inspections that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
; !,ACI I ,b4 07 08:15a Mcclenny Rhc 5 0 3 35 7 0 8 6 8 p . 2
• . •
Mechanical Permit A 1 1 lication .... 1 . FOR OFFICE USE ONLY
6 a r- , • • .
' „„.... i Received ij) ... /... ___. .4 A
.'1. - Date/Ry: ' - . /P 42.00 Pe an't'Vetrl - 0 6 3 - 6 ' 3
I ' 13125 SW Hall Blvd , Tig• Y,151 C; 1 ' - 7. Plan Revie •
1 - - 2 Phone: 503.639.4171 Fax. 503.598.1960 Date/By: Other Permit:
TIGARD 4
Inspection Line: 503.639A175
Date Ready/By: ( 0 See Page 2 for ------- -
Int wy.tigard OCT 0 _,.„ „...„.- 2001 - _ hats NotitlecVNIethod: Supplemental Information
171
,.-. - '' ' ' ..±. 1;. : ' - '.::::•-:': • t 04 .7typitie ::-.:„...„• 7 - r 7 ,..7 . 7:..7 - 4- 1 ,' NI. :• ; •:, COMMERCIAL FEE'' • SCHEIHJLE USE CHECKLIST 0 New construction 1/4s1"VPAILViNA41Wetitelint Mechanical permit fees* are based on the value of the work
performed. Indicate the value (rounded to the nearest dollar) of all
0 Demolition 0 Other: mechanical materials, equipment, labor, overhead, and profit.
- ' 2 .•- , ,j . -: . 1 • - .:: 1 174...T1E4oIty OF 'CONSTRUCTION :: .,'': - ...' : • ' .. ::.. ':..,:, Value: S
• RESIDENTIAL EQUIPMENT PSYSTEIVISFELS*: .
IEr 1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building
For special information use checklist.
0 Multi-family 0 Master builder El Other: Description Qty. Ea. I Total
. • ::-: '1 .- . zti*SITE..INTOIRIYIATTONAND LOCATION - .. -..... Heating/cooling
Air conditioning or heat pump
Job site address: ' CI I l ',..c . .....' / 1 0 ha, 4..., (requires site plan showing placement) - --1 1 -- 14.00 -- 1 4 1765 -
City/State/ZIP: /-"2767/9.fel 2c1R V. • Furnace 100,000 BTU (duets/vents) II 14.00
Furnace 100,000+ BTU (ducts/vent) 17.90
Suite/bIdglapt. no.: ("/ Project name: k 2 Li7Ae4i.
Gas heat pump 14.00
Cross street/directions to job site: (0i/i4/km/ 4.0. Duct work 14.00
Hydronic hot water system 14.00
Residential boiler (radiator or
hydronic) 14.00
Unit heaters (fuel-type, not electric),
in-wall, in-duct, suspended. etc. , 10.00
Flue/vent for any of above 1 10 10.00
Subdivision: Lot no.:
Other. 10.00
Tax map/parcel no.: Other fuel appliances
:....- : ..EIES.".O._RPPTION '0V-:. WORK' :' - .-'-:: , ": . '• . . .. Water heater 10.00
Gas fireplace
Itizi z zi i 71. 4 ■ 4 f i 4 /96i7. / Ay 6 , X6 z A e V Flue vent for water heater or gas 10.00
. ,... j fireplace 10.00
4,10 £?/ .- frrN7 ,..4
17N rizNi . / / Log lighter (gas) 10.00
4 iv
.
. • . .
ii/A „1 7,A;" g ',/ . „ t i , .,.. -- Wood/pellet stove 10.00
Wood fireplace/insert 10.00
Chimney/liner/flue/vent 10.00
. ;7:T" iii2OPEittk: 0)** . • 'I . ' -; : .. • • • . -:: 0 .4.7NANT: • : .• Other: 10.00
Name: ,/OA/ lea 1,...rAf Environmental exhaust and ventilation
Address: /60 9' Ciiivirly 6., ,i0., i kitchen
I 10.00 .
City/State/ZIP: 7 - ,i7/) 0 ie 47702(3y.: Clothes dryer exhaust 10.00
Single-duct exhaust (bathrooms,
Phone: (5w) - f - Si ii E Fax: ( ) toilet compartments, utility rooms) ' 6.80
E:,,A$1, ' ". :. -.,..-: - • -.• -:::,. - . 0: CONTACT PERSON .-. , - Artic/crawlspace fans I 1000 JO, (X)
Other: 10.00
Business name: e r: . az •
Fuel piping
Contact name: )5' -- '4,/ $5.40 for first four; $1.00 for each additional
Address: f i yg i , go> f, { j
r
Furnace, etc.
Gas heat pump
City/State/ZIP: ej:elovg 6 us ,',1 e 57/1/3- Wall/suspended/unit heater
Phone: (3) ( 557 - 3 - 643' Fax: : (5 c35 7 - - oa K Water ace
heater
Firepl i S. 90
E-mail: Range
.-.. - -• .H:..- ,...:::,'..,:. ONTRACTOTti !„ :-. .,. - : .: .. : . . ' ., . . -, :• - • . .-.' .. • Barbecue I • - 0 -
Business name: / 0
c (&-Akyy /,i6- Clothes dryer (gas)
Address: - 0 / P P3
• .-: - ': :::'.'.. ;"'.'...r;: - WCHANi - '
4,1 . _...,,A # II -
City/State/ZIP: (0 Ok 97//c5 . Subtotal -1t37617-
Minimum permit fee (S72.50) q 50
Phone: (..?) c 5-7 -,5-4if Fax: ( C5 - 123 ) - 3E5 - 7 - (,46e -
- Plan review (25% of permit fee)
CCB lie.: /9, 703 q'/55 /, State surcharge (8% of permit fee)
TOTAL PERMIT FEE 4-9
7 ;.; This permit application expires if a permit is not obtained within 180
Authorized signature: ., __
f2„a„ )24.....{,..
.„./.1_, days after it has been accepted as complete.
Print name: Etu..- /11W-Lovial,.. Date: je9 - ./ - o7 • Fee methodology set by Tri-County Building Industry Service Beard
1:\2uildinePermiisWEC-PermitAppdoc 006/06 440-4617T (I 1/02/COM/WEB) - 4 -- n.30
-ill'
P.ct `b4 07 08:15a Mcclenny Rhc 5033570668 p.3
230 Baseline Road
" . ' • . :LENNY/NC • P. O. Box 329
. s Comelius, Oregon 97113
Office: (503) 357 -5663
Refrigeration / Heating / Cooling Fax: (503) 357 - 0668
CCB #142703 k ti)
SITE PLAN O'
1 C '
. FL )
ouL
'I' to . .„ ,
.0,0k,(511,6 ..
1 3194 0 iJ ; V" t
PL q ?. ii (, ^^ , - ) PL
1 `vA`
•
f
. • 4 , 7
/41 6i.1 1 Y ) 4 1 & '
ia'
• v
PL
. - / 6 0 95 c iioy ()/ /< ('D '
STREET .
NOTE — Please show the following on the site plan: ' 1 •
•:• Location of Indoor Unit and Outdoor Unit
•: Indicate how the flue will be run (thru the roof — out the sidewall — et)
• Indicate with dotted line how'the lineset will be run and approx. disi�ance
• indicate how the condensate will be run
"Quality Service Is Our Only Business"
CITY OFTIGARD • .
��nm .� n���__N1��K��mu�� '
BUILDING DUNG DUVUSUON PERMIT #: kdEC2007- .
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/6/2007
[
Phone: (503) 639-4171
Inspection Requests (24Hmj:(5O3)G3Q'4175 .� l
1
INSPECTION WORKSHEET FOR DATE: 1088/2007 TIME: 7:00AIVI PAGE: 83
SITE ADDRESS: 100968yVQENTHRy OAK QR CLASS OF WORK:
SUBDIVISION: SUMMERFIELD LOT #: ow TYPE OF USE:
PROJECT NAME
: KOLINA
DESCRIPTION: Furnace and AC replace. Rturn air ducts, range venting, fan venting. Add gas to BBO and fireplace.
OWNER: KOUNA.R{)N PHONE #: 503-880-5145
I CONTRACTOR: MC CLENNY/RI-IC PHONE #: 503.357'5603
' Inspection Request Scheduled For: Date: 10/8/2007 Pour Time: ==1
Code # Inspection Description . # ����# M �
610 Gas line 057101'01 503-357'5653
91
Corrections/Comments/Instructions: 61
�
/�/�n�l
I |PAGS INI PARTIAL APPROVAL EL NO ACCESS
| | FAIL Ar iar' INSPECTION | I ADDITIONAL FEES ASSESSED
� ^^
inspector Oata� /�/��/ Phone (503) �-/~-�-
' v - / / #: . ' "--
,: //:' e' /C Mill
CITY OF TIGARD
BUILDING DIVISION
Ai PERMIT #: MEC2007-00583
D ATE 13125 SW Hall Blvd., Tigard, OR 97223 ISSUED: 10/5/2007
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 639-4175 .,_-_,M■ 1.1-.
INSPECTION WORKSHEET FOR DATE: 419/2008 TIME: 7:00AM PAGE: 24
SITE ADDRESS: 10095 SW CENTURY OAK DR CLASS OF WORK:
SUBDIVISION: SUMMERFIELD LOT #: 004 TYPE OF USE:
PROJECT NAME: KOLINA
DESCRIPTION: Furnace and AC replace. Return air ducts, range venting, fan venting. AO gas to 6130 and fireplace.
OWNER: KOLINA, RON PHONE #: 503-880-5145
CONTRACTOR: MC OLENNY/RHC PHONE #: 503-357-5663
Inspection Request Scheduled For: Date: 4/912008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 068082-01 503-357-5663 Y
Corrections/Comments/Instructions:
o
•
I IS 0 PARTIAL APPROVAL pi CANCEL 0 NO ACCESS
I I FAIL 1 I CALL FOR INSPECTION 7 ADDITIONAL FEES ASSESSED
Inspector:
) Date: 4-- --e Phone #: (503) 718-
CITY OF TIGARD ,tiT� p 1wl
BUILDING DIVISION
avrtkoi �� PERMIT #: MEC2007-00593
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1016/2007
Phone: (503) 639 -4171 � miirdjp u ii 6� �
Inspection Requests (24 Hrs.): (503) 639-4175
�e
INSPECTION WORKSHEET FOR DATE: 11/20/2007 TIME: 7:00AIVI PAGE: 45
SITE ADDRESS: 10095 S1+°. CENTURY OAK DR CLASS OF WORK:
SUBDIVISION: SUMMERF FLD LOT #: 004 TYPE OF USE:
PROJECT NAME: KOLINA
DESCRIPTION: Furnace and AC replace. Return air ducts, range venting, fan venting. Add gas to 13130 and fireplace.
OWNER: KOLINA, RON PHONE #: !a03- 1380-51'15 -
CONTRACTOR: MC CLENNY /RHC PHONE #: 503- 357 -5563
Inspection Request Scheduled For: Date: 11/20/2007 Pour Time:
t
Code # Inspection Description
/ Confirm # Contact # Message
615 Mechanical rough-in 059994 -01 503.880 -5145 Y p 0
Corrections /Comments /Instructions:
l'� e- - v 6/09-e- IT e4 1-z-e-v-A, l pi 0 s- di_idg
(. 1 1w4.
�4- I I m`:7-
,-- /� 4//f2i- PO //,'S ki /24,4,0-(45z157
� A1 a w Ok
(.., (9 k
4.1 c ( off- -- N- Q e 6,44141
4.� ) nll4 J Ok — W e I /z 1 v ,,l . 7/ Q -_
Y r ; '� o/c _ z 1 a 30 , =‘^- 114, i (*.
*clay, DR c 74/1 `,^ (A 6 (---e
( PARTIAL APPROVAL ❑ CANCEL ( I NO ACCESS
'l l FAIL H CALL FOR INSPECTION El ADDITI NAL FEES ASSESSED
Ins ector: Date: i D /07 Phone #: (503) 718 -I L I 0
p )
CITY OFTIGARD
BUILDING DIVISION PERMIT #: IVIEC2007-00583
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/5/2007
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 11/19/2007 TIME: 7:01AM PAGE: 45
SITE ADDRESS: 10096 SW CENTURY OAK DR CLASS OF WORK;
SUBDIVISION: SUMMERFIELD LOT #: 004 TYPE OF USE:
PROJECT NAME: KOLINA
DESCRIPTION: Furnace and AC replace. Return air ducts, range venting, fan venting. Add gas to 13BO . and fireplace.
OWNER: KOL1NA, RON PHONE #: 603-880-5145
CONTRACTOR: MC CLENNY/RHC PHONE #: 503-357-56(33
Inspection Request Scheduled For: Date: 11/19/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
610 Gas line 059855.02 503-357-6663
Corrections/Comments/Instructions:
Am _577"
7Th
ITO )
I PASS 0 PARTIAL APPROVAL I I CANCEL
Li FAIL 0 CALL FOR INSPECTION 0 ADDITIONAL FEES ASSESSED
Inspector: /// Date: /I-i. 7 Phone #: (503) 718-
, ,
• e ■ : • . — — 7
CITY OFTIGARD : . .
BUILDING DIVISION PERMIT #: MEC2007-00583
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 101E42007
Phone: (503) 639-4171 'A
ilviti#
Inspection Requests (24 Hrs.): (503) 639-4175 Jag- AL,
INSPECTION WORKSHEET FOR DATE: 11/19/2007 TIME: 7:01AM PAGE: 46
SITE ADDRESS: 10095 SW CENTURY OAK DR CLASS OF WORK:
SUBDIVISION: SUMMERFIELD LOT #: 004 TYPE OF USE:
PROJECT NAME: KOLINA
DESCRIPTION: Furnace and AC replace. Return air ducts, range venting, fan venting. Add gas to SBQ and fireplace.
OWNER: KOLINA, RON PHONE #: 603-880-5'146
CONTRACTOR: MC CLENNY/RI PHONE #: 503-357-6663
Inspection Request Scheduled For: Date: 11/19/2007 Pour Time:
' Code # Inspection Description Confirm # Contact # Message
G15 Mechanical rough-in 0591356-01 503-357-5663 V
Corrections/Comments/Instructions:
0 4-49 e■La 0.-,./ s .
PASS 7 PARTIAL APPROVAL 0 CANCEL 21-110
fl FAIL 7 CALL FOR INSPECTION 0 ADDITIONAL FEES ASSESSED
Inspector: ,
Date: 11 — ) Cy — a 7 Phone #: (503) 718-